ANEMIA AND ANYSOCYTOSIS IN THE EMERGENCY DEPARTMENT: A CROSS-SECTIONAL INVESTIGATION

Background: Anemia is a public healthcare problem, which is associated with increased morbidity and mortality. Some studies assessed the frequency of anemia in pediatric emergency departments (EDs), but no such information is available in adult patients admitted to the ED. Methods: The study population consisted of adult patients admitted to the ED of the Academic Hospital of Parma during the year 2010 with the five most frequent acute pathologies (i.e., acute myocardial infarction, AMI), renal colics, pneumonia, pancreatitis and major trauma). Hospital records were extracted from informatics database according to ICD-9 code and related terms. Routine hematological testing was performed on the entire population with identical instrumentation. Results: The study population consisted of 462 ED patients (cases; 262 renal colics, 62 pneumonia, 51 acute pancreatitis, 46 AMI and 41 major trauma) and 429 healthy blood donors (controls). The median hemoglobin value was significantly lower in all patients than in controls (137 versus 151 g/L; p<0.01), whereas the median RDW value was significantly higher (13.7 versus 13.4%; p<0.01). The frequency of anemia and anysocytosis was higher in patients than in controls (anemia: 23 versus 4%, p<0.01; anysocytosis: 25 versus 16%; p=0.03). Hemoglobin values of all subclasses of patients were significantly lower than those of the controls, while those of RDW were significantly increased in patients with AMI, pancreatitis and pneumonia. Conclusions: We found a high prevalence of anemia and anysocytosis in a population of ED patients, whose identification may be vital for appropriate therapy and subsequent management.